王　财，张玉霞，陈志余，瞿述根，王晓莉，陈　凡※

(1.青海大学附属医院；2.青海大学医学院)



MMP-9、TIMP-1在放疗后乳腺癌患者中的表达及其临床意义*

王财1，张玉霞2，陈志余2，瞿述根2，王晓莉1，陈凡1※

(1.青海大学附属医院；2.青海大学医学院)

摘要目的探讨MMP-9、TIMP-1在乳腺癌患者放疗后的表达及其临床意义。方法收集40例乳腺癌患者放疗前后的血清，以ELISA法检测MMP-9、TIMP-1表达，并分析其与年龄、TNM分期、肿瘤长度、淋巴结转移情况的相关性。结果MMP-9、TIMP-1表达在乳腺癌患者的年龄、TNM分期、肿瘤长度及淋巴结转移之间有统计学差异(P<0.05)；与放疗前比较，MMP-9表达上升，TIMP-1下降(P<0.05)，MMP-9/TIMP-1比值增加(P<0.05)。Kaplan-Meier分析发现，中位生存期为36.00(95%CI=35.13~36.88)个月。放疗前、后MMP-9/TIMP-1比值高度相关，R=0.907。结论乳腺癌患者放疗后MMP-9、TIMP-1表达改变，与患者预后密切相关，可作为乳腺癌放疗后预后的重要指标。

关键词乳腺癌放疗基质金属蛋白酶-9基质金属蛋白酶抑制剂-1

CLINICAL SIGNIFICANCE OF MMP-9 AND TIMP-1

EXPRESSION IN BREAST CANCER AFTER RADIOTHERAPY*

Wang Cai1，Zhang Yuxia2，Chen Zhiyu2，Qu Shugen2，Wang Xiaoli1，Chen Fan1※

(1.Qinghai University Medical College；2.Qinghai University Affiliated Hospital)

Abstract ObjectiveTo investigate the clinical significance of MMP-9 and TIMP-1 expression after radiotherapy in breast cancer.Methods Serum of 40 breast cancer patients were collected before and after radiotherapy.The expression of MMP-9 and TIMP-1 were measured by ELISA，and analyzed the relationship between age，TNM stage，tumor length，and lymphatic metastasis.Results There was statistics difference in age，TNM stage，tumor length and lymphatic metastasis in patients with breast cancer by means of the expression of MMP-9 and TIMP-1(P<0.05).The expression of MMP-9 was increasing compared with pre-radiotherapy，as to MMP-9/TIMP-1 ratio，the TIMP-1 was decreased(P<0.05).The median survival time was 36.00(95% CI=35.13~36.88) months by Kaplan-Meier.There was high correlation of MMP-9/TIMP-1 ratio before and after radiotherapy with equal to 0.907 of R.Conclusion There is changed expression of MMP-9 and TIMP-1 and has closely correlated with the prognosis of patients，and can be used as an important index of prognosis in breast cancer after radiotherapy.

KeywordsBreast cancerRadiation therapyMMP-9TIMP-1

尽管有许多关于MMP-9、TIMP-1在肿瘤组织中的表达研究，但在放疗后的乳腺癌研究未见报道[1，2]。本研究拟就其相关关系报告如下。

1资料与方法

1.1临床资料

收集40例在青海大学附属医院行根治术或保乳术后首程在放疗科住院接受放射治疗的女性乳腺癌患者进行回顾性研究，年龄34~71(中位年龄为55.1±12.7)岁，均经组织病理学确诊。其中I期6例，Ⅱ期21例，Ⅲ期13例，肿瘤长度<2 cm者10例，2~5 cm者19例，>5 cm者11例，无局部淋巴结转移者15例，有转移者25例。KPS≥80分，排除其他慢性病(肺心病、糖尿病、高血压等)。

1.2放疗方案

所有患者均仰卧位于X线模拟下用负压垫固定体位，CT模拟机下定位后，行6 MeV电子线胸壁切线野照射，照射范围：上界与腋锁野下界接野，内界与内乳野相接，外界为腋中线，下界为对侧乳房皱褶下2 cm；模拟机下观察切肺边界不超过2.5 cm，常规加300的楔形板，总剂量为50 Gy，常规分割2 Gy/次，5 次/周。

1.3因子检测方法

于放疗前、后清晨空腹抽取静脉血2 mL于依地酸(EDTA)抗凝管中，离心(5000r/min)10 min，收集血清于冻存管中，-80 ℃超低温保存备用。……